NICHOLAS ANTHONY AMIGONI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

ANTHONY

Last Name

AMIGONI

Suffix

DDS

Business Name

NICHOLAS ANTHONY AMIGONI DDS

Original Issue Date

03/06/2001

Effective Date

06/08/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012